NPI | 1356645550 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: WA 60087603) |
Additional Taxonomies | 183500000X Pharmacist (Licence: GA 023302) |
Enumeration Date | 2011-01-03 |
Last Update Date | 2011-01-03 |